Temperament and character traits among suicidal patients during depressive episode of bipolar disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. s890-s891
Author(s):  
A. Petek Eric ◽  
I. Eric ◽  
K. Dodig-Curkovic ◽  
K. Kralik ◽  
P. Filakovic
Keyword(s):  
Bipolar Disorder ◽  
General Population ◽  
Mood Disorders ◽  
Depressive Episode ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Treatment ◽  
Bipolar Patients ◽  
Personality Features ◽  
Suicidal Patients

IntroductionBoth suicide and mood disorders represent current and future global burden on public health system. Bipolar disorder (BD), part of a diagnostic group of mood disorders, is characterized by manic, depressive and mixed episodes with life-expectancy much shorter than in general population. Patients with BD have 30 times higher suicide rate than the general population and 25–50% of these patients attempts suicide. About 15% of patients who attempted suicide eventually end their lives with completed suicide.AimThe aim of our research was to distinguish personality features among bipolar patients with current depressive episode (BD-D) who attempted suicide.Materials and methodsThe research was conducted among patients with depressive episode of BD (according to diagnostic criteria of ICD–10) who attempted suicide and had been admitted for hospital psychiatric treatment. For assessment of personality, we used the Temperament and Character Inventory (TCI, Cloninger R.) upon admittance. Our sample consisted of 31 (n = 31) patient who met the above mentioned criteria. All patients given their written informed consent. The statistical analysis was performed using SPSS 17.0.ResultsIn our sample, we found, higher scores on harm-avoidance (HA), significantly higher scores on novelty seeking (NS) with significantly lower scores on persistence (P), self-directedness (SD) and cooperativeness (C) scales of the TCI. The Mann–Whitney-U test was used to compare samples.ConclusionIn our sample, suicide attempts are associated with temperament and character dimensions. These results confirmed our initial hypotheses on existence of specific personality features among that group of suicidal patients with BD–D.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Clinical Characteristics Associated with Suicide Attempt in Patients with Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S94-S94
Author(s):  
M.-E.-M. Vismara ◽  
B. Dell’Osso ◽  
C. Dobrea ◽  
L. Cremaschi ◽  
G. Benedetta ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Suicide Attempt ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Analysis Of Covariance ◽  
Variable Effect ◽  
Clinical Variables ◽  
Risk Patients ◽  
Competing Interest ◽  
Bipolar Patients

IntroductionBipolar disorder (BD) is a chronic, highly disabling condition, associated with a high burden of morbidity and mortality, often secondary to suicidal behaviors. In previous reports, different variables have been associated with a higher risk of suicidal acts, with variable effect.ObjectivesTo evaluate which socio-demographic and clinical variables correlate with suicide attempts in bipolar patients.AimsTo enrich literature data about suicidal behaviour in BD.MethodsA sample of 362 BD patients (DSM IV-TR) was retrospectively collected and divided in two subgroups, in relation to the presence of a previous suicide attempt. Socio-demographic and clinical variables were compared between attempters and non-attempters using Corrected multivariate analysis of covariance (MANCOVA).ResultsA total of 26,2% of analyzed patients attempted suicide in their lifespan, and approximately one third of them had multiple suicide attempts (i.e. ≥ 2; 31%). Depressive polarity at index mood episode, higher number of psychiatric hospitalizations, comorbidity with alcohol abuse, eating disorders and psychiatric poly-comorbidity were significantly associated with suicide attempt. Additionally, treatment with lithium, poly-pharmacotherapy (≥ 4 current drugs) and higher recurrence of psychosocial rehabilitation were significantly more frequent in patients who attempted suicide.ConclusionsThe present paper reported a correlation with some specific clinical variables and the lifetime presence of suicide attempt in patients with BD. Although these retrospective findings did not address the causality issue, they may be of clinical relevance in order to better understand suicidal behavior in BD and to adopt proper strategies to prevent suicide in higher risk patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Suicide Attempts During Adolescence: Systematic Hospitalization and Crisis Treatment

Crisis ◽  
1999 ◽  
Vol 20 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Jérôme Ottino
Keyword(s):  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Treatment ◽  
Health Workers ◽  
Inpatient Unit ◽  
Theoretical Hypothesis ◽  
Initial Resistance ◽  
Provision Of Care ◽  
Suicidal Crisis

This paper deals with an inpatient unit that recently opened in Geneva, specializing in the treatment of patients aged 16-21 years who had attempted suicide or felt the desire to commit suicide. This particular center was established because of the significant weaknesses found in the provision of care to adolescents who had attempted suicide. Despite the growing interest of health workers in this area of study over recent years, the frequency of suicide among the young has not decreased and there are numerous recurrences of the suicide attempts. Further, all efforts to improve the adolescents' compliance with psychiatric treatment have failed to date. The number of drop-outs from treatment is still very high. Thus, the objectives of our inpatient unit are as follows: (1) to overcome initial resistance to treatment and to improve long-term compliance; (2) to decrease the number of recurrent attempts as a consequence of the above, thus increasing life expectancy; (3) to offer the adolescents who have tried (or have contemplated) committing suicide an improved quality of life, after first helping them overcome the suicidal crisis. To achieve these goals, the therapeutic team of the unit proposes short stays during which the work with the adolescents consists of a very intensive psychoanalytic-oriented crisis intervention. Numerous practical aspects of our therapeutic approach in the inpatient unit are related here in detail, always with reference to our theoretical hypothesis.

Baseline and prodromal characteristics of first- versus multiple-episode mania in a French cohort of bipolar patients

2011 ◽  
Vol 27 (8) ◽  
pp. 557-562 ◽  
Author(s):  
J.-M. Azorin ◽  
A. Kaladjian ◽  
M. Adida ◽  
E. Fakra ◽  
E. Hantouche ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Suicide Attempts ◽  
Correct Diagnosis ◽  
Manic Episode ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Prodromal Phase ◽  
Multiple Episode ◽  
Patients At Risk ◽  
Bipolar Patients

AbstractObjective:To identify some of the main features of bipolar disorder for both first-episode (FE) mania and the preceding prodromal phase, in order to increase earlier recognition.Methods:One thousand and ninety manic patients (FE=81, multiple-episodes [ME]=1009) were assessed for clinical and temperamental characteristics.Results:Compared to ME, FE patients reported more psychotic and less depressive symptoms but were comparable with respect to temperamental measures and comorbid anxiety. The following independent variables were associated with FE mania: a shorter delay before correct diagnosis, greater substance use, being not divorced, greater stressors before current mania, a prior diagnosis of an anxiety disorder, lower levels of depression during index manic episode, and more suicide attempts in the past year.Conclusion:In FE patients, the diagnosis of mania may be overlooked, as they present with more psychotic symptoms than ME patients. The prodromal phase is characterised by high levels of stress, suicide attempts, anxiety disorders and alcohol or substance abuse. Data suggest to consider these prodromes as harmful consequences of temperamental predispositions to bipolar disorder that may concur to precipitate mania onset. Their occurrence should therefore incite clinicians to screen for the presence of such predispositions, in order to identify patients at risk of FE mania.

Thought overactivation as a marker of bipolar disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. s222-s223 ◽  
Author(s):  
M. Ferrari ◽  
P. Ossola ◽  
V. Lucarini ◽  
V. Accardi ◽  
C. De Panfilis ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
Subjective Experience ◽  
Small Sample Size ◽  
Mental States ◽  
Small Sample ◽  
Bipolar Spectrum ◽  
Global Functioning ◽  
Competing Interest ◽  
Bipolar Patients

IntroductionRecent studies have underlined the importance of considering the form of thoughts, beyond their content, in order to achieve a better phenomenological comprehension of mental states in mood disorders. The subjective experience of thought overactivation is an important feature of mood disorders that could help in identifying, among patients with a depressive episode, those who belong to the bipolar spectrum.ObjectivesPatients with a diagnosis of bipolar disorder (BD) were compared with matched healthy controls (HC) on a scale that evaluates thought overactivation.AimsValidate the Italian version of a scale for thought overactivation (i.e. STOQ) in a sample of bipolar patients.MethodsThirty euthymic BD and 30 HC completed the Subjective Thought Overactivation Questionnaire (STOQ), the Ruminative Responses Scale (RRS), the Beck Depression Inventory-II (BDI-II) and global functioning (VGF).ResultsThe 9-items version of the STOQ has been back translated and its internal consistency in this sample was satisfactory (alpha = .91). Both the brooding subscore of RRS (b-RRS) (r = .706; P < .001) and STOQ (r = .664; P < .001) correlate significantly with depressive symptoms whereas only the first correlate with VGF (r = –.801; P < .001). The two groups did not differed in the b-RRS (HC = 8.41 vs BD = 9.72; P = .21), whereas BD where significantly higher in the STOQ total score (HC = 6.62 vs. BD = 14.9; P = .007).ConclusionOur results, although limited by the small sample size, confirm the validity of the STOQ and suggest that this scale could grasp a feature characteristic of BD, independently from their tendency to ruminate. The latter seems to impact more on global functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Risk of Child Abuse among Mothers who Attempt Suicide

1985 ◽  
Vol 146 (5) ◽  
pp. 486-489 ◽  
Author(s):  
Keith Hawton ◽  
Jacqueline Roberts ◽  
Guy Goodwin
Keyword(s):  
At Risk ◽  
Child Abuse ◽  
General Population ◽  
Young Children ◽  
General Hospital ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Population Control ◽  
Not At Risk ◽  
The Relationship

SummaryThe association between parental attempted suicide and child abuse was investigated in 114 mothers with children aged five years and under, referred to a general hospital following suicide attempts. The risk was greatly increased in the attempted suicide mothers, compared with both similar mothers at risk for depression and general population control mothers; well-documented risk of child abuse was identified in 29.8% of those who attempted suicide. No major differences were found between the attempted suicide mothers whose children were at risk and those whose children were not at risk. During the general hospital assessment of mothers with young children who attempt suicide, careful enquiry concerning the relationship with the children is essential

Differences in cholesterol and metabolic syndrome between bipolar disorder men with and without suicide attempts

2009 ◽  
Vol 21 (S2) ◽  
pp. 66-69 ◽  
Author(s):  
Bjanka Vuksan-Ćusa ◽  
Darko Marčinko ◽  
Sanea Nad ◽  
Miro Jakovljević
Keyword(s):  
Metabolic Syndrome ◽  
Bipolar Disorder ◽  
General Population ◽  
Serum Cholesterol ◽  
Suicide Attempts ◽  
Statistical Significance ◽  
Mental Illnesses ◽  
Blood Cholesterol ◽  
Relative Risk Ratio ◽  
Cholesterol Levels

Abstract:Patient with mental illnesses such as schizophrenia and bipolar disorder have an increased prevalence of metabolic syndrome (MetS) and its components compared to general population. Among psychiatric disorders, bipolar disorder ranks highest in suicidality with a relative risk ratio of completed suicide of about 25 compared to the general population. Regarding the biological hypotheses of suicidality, low blood cholesterol level has been extensively explored, although results are still conflicting. The aim of this study was to investigate whether there were differences in the serum cholesterol levels in hospitalized bipolar disorder men patients with history of suicide attempts (n= 20) and without suicide attempts (n= 20). Additionally, we investigated if there were differences in the prevalence of MetS according to NCEP ATP-III criteria in these two groups of patients. Results of the study indicated significantly lower serum cholesterol levels (P = 0.013) and triglyceride levels (P = 0.047), in the bipolar disorder men with suicide attempts in comparison to bipolar disorder men without suicide attempts. The overall prevalence of MetS was 11/40 (27.5%). On this particular sample it was higher in the non-attempters 8/20 (40.0%) than in attempters 3/20 (15.0%) bipolar men group, but without statistical significance. Lower concentrations of serum cholesterol might be useful biological markers of suicidality in men with bipolar disorder.

Bipolar disorder and co-occurring cannabis use disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S466-S466
Author(s):  
S. Ben Mustapha ◽  
W. Homri ◽  
L. Jouini ◽  
R. Labbane
Keyword(s):  
Bipolar Disorder ◽  
Suicide Attempts ◽  
Term Treatment ◽  
Cannabis Use ◽  
Family Dynamic ◽  
Long Term Treatment ◽  
Cannabis Use Disorders ◽  
Competing Interest ◽  
Bipolar Patients ◽  
Psychotic Features

AimsAssess the prevalence of cannabis use disorders (CUD) in patients with bipolar disorder, describe the demographic and clinical profile socio bipolar patients with comorbid addictive and assess the implications of this comorbidity on prognosis and evolution of bipolar disorder.MethodsA case-control study, 100 euthymic patients treated for bipolar disorder, recruited in the department of psychiatry C of Razi hospital. Two groups were individualized by the presence or not of cannabis use disorders comorbidity. The two groups were compared for sociodemographic, clinical, therapeutic and historical characteristics.ResultsThe prevalence of CUD was 27.53% (n = 19) in our sample. Comparing bipolar patients according to the presence or absence of CUD, we found the following results with patients with CUD comorbidity: younger, mostly male, a disturbed family dynamic, low educational level, poor socio-economic conditions, more time abroad history, more suicide attempts in history, more criminal record, more psychiatric family history, an earlier onset of the disease, a longer duration of undiagnosed bipolar disorder, more personality disorder, more frequent presence of a triggering factor for bipolar disorder, more psychotic features during mood episodes, more need of antipsychotic long-term treatment.ConclusionsThe frequency of CUD in BD is higher than the prevalence in the general population and CUD is a factor in the evolution and prognosis of bipolar disorder and promotes the development of mood disorders in predisposed patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Suicidal Career in Severe Depression among Long-Term Survivors: In a Followup after 37–53 Years Suicide Attempts Appeared to End Long before Depression

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Lisa Crona ◽  
Alexander Mossberg ◽  
Louise Brådvik
Keyword(s):  
Suicide Attempt ◽  
Depressive Episode ◽  
Medical Records ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Healing Process ◽  
Severe Depression ◽  
Long Term Survivors ◽  
Course Of Depression

Objective. To describe the suicidal career in the long-term course of severe depression.Subjects and Method. Seventy-five former in-patients were interviewed by telephone about course of depression and suicide attempts 37–53 years after index admission. Medical records were read in many cases.Results. 29 subjects had attempted suicide, 13 repeated, 10 made severe, and 13 violent attempts. The risk of suicide attempt decreased by 10% for every decade spent depressed. Suicide attempts were made early in course of depression, and more time was spent depressed after suicide attempts than before.Conclusions. A healing process of the suicidal career, which may occur long before the end of the last depressive episode (sometimes decades), is proposed.

Bipolar Disorder and Cannabis

2017 ◽  
Vol 41 (S1) ◽  
pp. S118-S119
Author(s):  
G. Jmii ◽  
M. Zghal ◽  
F. Ghali ◽  
M. Mezghenni ◽  
L. Jouini ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Substance Dependence ◽  
Suicide Attempts ◽  
Bipolar Disorders ◽  
Cross Sectional Study ◽  
Cannabis Use ◽  
Type I ◽  
Cross Sectional ◽  
Average Hospital ◽  
Bipolar Patients

IntroductionPeople with bipolar disorder frequently struggle with substance abuse and dependence. Typically, cannabis is the most commonly abused drug in individuals with bipolar disorder. Some investigators have implied that cannabis may actually be mood stabilizing in patients with bipolar disorder. However, the relationships between cannabis use and bipolar disorders are complex and remain incompletely described.ObjectiveThe aim of this study was to identify the characteristics of addiction to cannabis in bipolar patients type I and determine the consequences of cannabis on the expression of bipolar illness and prognosis.MethodsThis is a comparative cross-sectional study which included patients followed in the psychiatry department of the G Razi hospital for bipolar disorder type I and for substance dependence according to DSM IV diagnostic criteria. Hetero-questionnaire on sociodemographic variables, clinical and treatment.ResultsThe average age was 41 years. The average hospital stay was 9.18 days. 33.33% of patients were monitored regularly. Most patients were single and worked as a day labourer. Cannabis was the most consumed substance. Cannabis use was prior to the expression of psychiatric illness in 55% of cases. The average number of hospitalisation in patients with a cannabis addiction was significantly greater than that observed in the non-addicted group. Similarly, the average number of suicide attempts among patients with cannabis addiction was significantly higher than the group without cannabis addiction.ConclusionsAggressive drug abuse treatment immediately after a first psychiatric hospitalisation might decrease rates of recurrence and new cases of cannabis use disorder in the course of bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The Use of Cannabis as a Predictor of Early Onset of Bipolar Disorder and Suicide Attempts

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Rafaela Torres Portugal Leite ◽  
Sarah de Oliveira Nogueira ◽  
João Paulo Rodrigues do Nascimento ◽  
Laisa Soares de Lima ◽  
Taís Bastos da Nóbrega ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Early Onset ◽  
Suicide Attempts ◽  
Age At Onset ◽  
Prognostic Significance ◽  
Manic Episode ◽  
Cannabis Use ◽  
Pubmed Database ◽  
Increased Risk ◽  
Bipolar Patients

Introduction. Bipolar disorder (BD) implies risk of suicide. The age at onset (AAO) of BD carries prognostic significance. Substance abuse may precede the onset of BD and cannabis is the most common illicit drug used. The main goal of this study is to review the association of cannabis use as a risk factor for early onset of BD and for suicide attempts.Materials and Methods. PubMed database was searched for articles using key words “bipolar disorder,” “suicide attempts,” “cannabis,” “marijuana,” “early age at onset,” and “early onset.”Results. The following percentages in bipolar patients were found: suicide attempts 3.6–42%; suicide attempts and substance use 5–60%; suicide attempts and cannabis use 15–42%. An early AAO was associated with cannabis misuse. The mean age of the first manic episode in individuals with and without BD and cannabis use disorder (CUD) was 19.5 and 25.1 years, respectively. The first depressive episode was at 18.5 and 24.4 years, respectively. Individuals misusing cannabis showed increased risk of suicide.Discussion. Cannabis use is associated with increased risk of suicide attempts and with early AAO. However, the effect of cannabis at the AAO and suicide attempts is not clear.

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